FLORIDA ~ STATUTE , and Florida Statutes

Transcription

1 FLORIDA ~ STATUTE STATUTE DATE Enacted 1976 REGULATORY BODY PA DEFINED SCOPE OF PRACTICE PRESCRIBING/DISPENSING SUPERVISION DEFINED , and Florida Statutes Council on Physician Assistants; Florida Board of Medicine, Florida Department of Health A person who is a graduate of an approved program or its equivalent or meets standards approved by board and who is licensed to perform medical services delegated by supervising physician (2) Board to adopt by rule the general principles that supervising physicians must use in developing scope of practice of PA under their supervision (4) PA may not be denied clinical hospital privileges except for cause, so long as supervising physician is staff member in good standing (4) Supervising physician may delegate to a fully licensed PA the authority to prescribe or dispense any medication used in the physician s practice unless such medication is listed on the formulary. (Formulary of drugs PAs may not prescribe must include controlled substances, antipsychotics, general anesthetics, radiographic contrast and all parenterals except insulin and epinephrine.) Authority to dispense may only be granted to a PA by a supervising physician who is registered as a dispensing practitioner. PA must inform patient that medication is prescribed or dispensed by a PA and the patient has the right to see the physician prior to prescription being issued. Prior to prescribing or dispensing PA must file evidence of 3 hours of CME in prescriptive practice (evidence of such training as part of PA program accepted), evidence of 3 months of clinical experience in the specialty of the supervising physician and a signed affidavit that the PA has completed 10 hours of CME in the specialty practice in which the PA has prescriptive privileges. Department issues PA a prescriber number. PA must note the prescription or dispensing of medication in the appropriate medical record, and the supervising physician must review and sign each notation (4) Responsible supervision and control. Except in cases of emergency, supervision shall require the easy availability or physical presence of licensed physician for consultation and direction of PA actions. Easy availability includes telecommunication. Board to set rules as to what constitutes reasonable and responsible supervision (2) A physician offering primary health care services may supervise PAs at no more than four satellite offices, in addition to the primary place of practice. A physician offering specialty health care services may supervise PAs at no more than two satellite offices, in addition to the primary place of practice. A physician offering primarily dermatologic or skin care services, which include aesthetic skin care services other than plastic surgery, may only supervise PAs at one satellite office, in addition to the primary place of practice. Physician must comply with the following requirements: The supervising physician may supervise PAs in a second satellite office until July 1, 2011, if the physician notified the Board of Medicine of the address of the two satellite offices no later than June 30, 2006; The physician must be board certified or board-eligible in dermatology or plastic surgery; The satellite office must be within 25 miles of the supervising physician, unless it is in an adjacent county, in which case the distance must be no more than 75 miles from the primary practice location; and PAs in these satellite offices are not required to have their charts reviewed by the supervising physician. A physician who supervises PAs in satellite offices must post in each office a current schedule of the regular hours that the physician is present in that office, and the hours that the office is open when the physician is not present. Most institutional supervised settings including, but not limited to, hospitals, rural health clinics, nursing homes, and medical student and resident training are exempted from the above requirements (4) PAs PER PHYSICIAN APPLICATION Physician may not supervise more than 4 currently licensed PAs at any one time (3) PA must apply to the department and submit proof of qualifications, 2 letters of recommendation, sworn statements. Upon employment licensed PA must notify department of name, address, license number and specialty of supervising physician (7)

2 FLORIDA ~ STATUTE QUALIFICATIONS TEMPORARY PERMIT TERMINATION Department shall issue license to each applicant who: is at least 18 years old has passed NCCPA exam (applicant who does not hold a current certificate and has not actively practiced as a PA within the immediately preceding 4 years must retake and successfully complete NCCPA s PANCE exam) has submitted certificate of completion of approved PA program (7) Department shall examine applicant who: was eligible and made initial application for certification as PA in Florida between July 1, 1990 and June 30, 1991 is an unlicensed physician who graduated from a foreign medical school listed with WHO who has not previously taken and failed the NCCPA exam is certified by the medical board as having met the requirements for licensure as a medical doctor by examination with the exception that residency not required and passage of medical licensing examination not required (7) Department may grant temporary license to recent graduate which expires upon receipt of scores from NCCPA or results of agency-administered exam. Expires upon failure of examination. Potential temporary licensee may apply for one-time extension of temporary license after applying for next available examination. If applicant fails exam twice, no longer eligible for temporary license (7) PA must notify board within 30 days of employment or change in supervising physician(s) (7) CONTINUING EDUCATION 100 hours biennially or current NCCPA certification (7) TITLE/PRACTICE PROTECTION IDENTIFICATION Any person who has not been licensed by council and approved by department who holds himself out as a PA or who uses any other term in indicating or implying that he is a PA, is guilty of third degree felony (11) PHYSICIAN LIABILITY FEE/RENEWAL SCHEDULE PROGRAM APPROVAL BOARD REPRESENTATION/ ADVISORY COMMITTEE BOARD POWERS DISCIPLINARY POWERS Each physician using PA is liable for any acts or omissions of the PA under his supervision (15) $300 limit on initial PA licensure fee $500 limit on biennial PA license renewal fee (7) Board shall approve PA education programs based on recommendations by the council. Only programs accredited by the Commission on Accreditation of Allied Health Education Programs or its successor will be approved (6) Five member Council on Physician Assistants within the Department of Health. Chairman of the Board of Medicine appoints 3 members who are physician medical board members. One must supervise a PA. Chairman of the Board of Osteopathic Medicine appoints 1 physician board member. Secretary of the department appoints 1 licensed PA. Two members must be physicians who supervise PAs. Council elects chairman annually. The council shall: recommend PAs for licensure develop all rules regulating PAs. Identical rules must be adopted by both boards. make recommendations to the boards regarding all matters relating to PAs (9) Council to establish formulary of drugs that licensed PAs may not prescribe. Formulary must include controlled substances, antipsychotics, general anesthetics, radiographic contrast and all parenterals except insulin and epinephrine. Boards must adopt the formulary (4) Adopt rules necessary for administration of PA process Adopt rules detailing contents of licensure application Adopt rules necessary to ensure continued competency of PAs and their proper utilization by physicians or groups of physicians (13) Deny license, impose sanctions, order probation, or place restrictions on PA license, require treatment or CME courses, require additional supervision, (7), (9) Deny, suspend or revoke PA license (12)

3 FLORIDA ~ STATUTE VIOLATIONS/PENALTY PAYMENT FOR SERVICES GRANDFATHER CLAUSE Board may impose penalties on PA or supervising physician for violation of medical practice act or health professions and occupations statute (7) Health insurance policies must provide payment for PA first assistant if such coverage would have been provided for physician first assistant in surgery STUDENTS Trainee may perform medical services within scope of approved program (5) LOCUM TENENS OTHER In 1990 the Florida legislature passed an amendment making graduates of foreign medical schools who had achieved a score of 65 or higher on the FLEX or ECFMG exams eligible for state approval as PAs. An injunction prevented this law from going into effect. In 1991 the legislature repealed this amendment, replacing it with provisions for (1) the establishment of a PA program at Miami-Dade Community College designed for foreign medical school graduates, and (2) the one-time administration of an examination for WHOapproved medical school graduates residing in Florida who applied by June 30, Law was later amended to allow examination to be administered 5 times. Those who passed the exam would be eligible for state PA licenses valid only in Florida. In 2001 the state passed a law abolishing all state-developed and administered examinations.

4 FLORIDA ~ REGULATIONS REGULATIONS Chapter 64B8-30, F.A.C. DATE Revised 11/07 REGULATORY BODY PA DEFINED SCOPE OF PRACTICE PRESCRIBING/DISPENSING SUPERVISION DEFINED PAs PER PHYSICIAN APPLICATION QUALIFICATIONS TEMPORARY PERMIT TERMINATION CONTINUING EDUCATION Florida Board of Medicine Supervising physicians shall delegate only tasks and procedures that are within their scope of practice. PA may not perform final diagnosis. Certain duties may not be performed under indirect supervision, such as routine insertion of chest tubes, cardiac stress testing, and insertion of central venous catheters. Administration of general, spinal and epidural anesthesia may be performed under direct supervision (physician on premises) only by PAs who have graduated from board-approved anesthesiology assistant programs. All tasks and procedures performed by PAs must be documented in the appropriate medical record. PA will act in accordance with his or her training and knowledge in medical emergency until physician assumes responsibility for the patient. 64B To prescribe, PA and supervising physician(s) must file application. Prescribing PA must have completed 3 hour course in prescriptive practice after graduation from PA program. Prescribing PA must have completed 3 months of clinical experience in the specialty area of the supervising physician. Board issues prescriber number to PA. 64B (5) Supervising physician and prescribing PA must enter into a written agreement outlining which drugs the physician has authorized PA to prescribe. Agreement to be kept on file at the practice and provided to the Board upon request. 64B PAs may not prescribe controlled substances, antipsychotics, general, spinal, or epidural anesthetics, radiographic contrast materials and parenterals (with exception of insulin and epinephrine). Physician may delegate PA to prescribe only drugs used in physician s practice. 64B Only prescribing PAs may dispense sample drugs to patients. All sample dispensing must be done without charge to the patient, and PAs may only dispense those drugs that they are authorized to prescribe. PAs practicing in county health departments may dispense prepackaged and prelabeled medications. 64B Responsible supervision means physician s ability to exercise control and provide direction over PA services. Requires easy availability or physical presence of supervising physician. Factors to be considered in judging if supervision is adequate include task complexity, patient risk, PA s skill, setting, physician availability, necessity for immediate attention, and the number of other persons that the physician must supervise. Direct supervision refers to physical presence of supervising physician on premises so physician is immediately available to PA when needed. Indirect supervision means easy availability, including by telecommunications; must be within reasonable physical proximity. 64B Supervising physician must review and sign PA s medical records within 7 days during initial 6 months of supervision; within 30 days thereafter. 64B Application for licensure must be submitted on board forms, including two letters of recommendation from physicians. 64B Applicants who have not passed PANCE exam within 5 attempts must complete 3 months of full-time review course in accredited PA program. Applicants must submit statements attesting to completion of 2 hours of CME on prevention of medical errors. 64B Upon any change in employment status the PA shall submit to the board a PA supervision data form within 30 days. Supervising physician must notify board in writing within 30 days of any termination of PA supervised. 64B All licensed PAs shall obtain 100 hours of CME biennially that have been approved by the AAPA and logged with either AAPA or NCCPA. Must submit statement documenting completion of 2 hours in prevention of medical errors. Prescribing PAs must complete a minimum of 10 hours of CME in specialty area of supervising physician biennially (these hours may be used to meet 100 hour requirement).

5 FLORIDA REGULATIONS TITLE/PRACTICE PROTECTION IDENTIFICATION PHYSICIAN LIABILITY PA must complete 2 hours of CME in domestic violence every 6 years. PA must document 1 hour of HIV/AIDS CME prior to renewing license for the first time. 64B Licensees shall identify themselves as PAs in one of the following manners: (1) wearing a name tag identifying themselves as PAs; (2) wearing of an article of clothing on the upper body which identifies them as PAs; (3) verbally disclosing themselves as PAs to patients; (4) providing patients with written documentation (e.g. business card) identifying themselves as PAs; (5) placing photos identifying PAs in the lobby or waiting room of practice location. 64B Physician assumes responsibility and legal liability for services rendered by PA at all times PA is under his supervision. 64B FEE/RENEWAL SCHEDULE PROGRAM APPROVAL BOARD REPRESENTATION/ ADVISORY COMMITTEE BOARD POWERS $100 license application fee $200 initial PA license fee $150 PA biennial renewal fee $200 application fee for prescribing PA $150 biennial renewal fee for prescribing PA 64B Any program wishing to be approved and recognized must be accredited by CAHEA. 64B DISCIPLINARY POWERS Issue notice of noncompliance. 64B Denial, reprimand, issue letter of concern, fines, probation, suspension, revocation. 64B VIOLATIONS/PENALTY Grounds for disciplinary action include: failure to include disclosure statement in advertisement failure to notify board of change of practice location failure to clearly identify self as PA failure to report change in supervising physician obtaining license renewal by negligent misrepresentation practicing on inactive or delinquent license fraud in attempting to obtain license action taken against license in another jurisdiction guilty of crime directly relating to practice false advertising failure to report another licensee in violation aiding unlicensed practice failure to perform legal obligation failure to document required CME failure to report conviction of crime failure to disclose financial interest to patient filing a false report or failure to file kickbacks or fee splitting sexual misconduct fraudulent representations of medical practice improper solicitation of patients failure to keep written medical records exercising influence on patient for financial gain performing professional services not authorized by patient inappropriate prescribing prescribing or dispensing scheduled drug to self inability to practice with skill and safety malpractice; practicing below acceptable standard of care performing experimental treatment without informed consent practicing beyond permitted scope delegation of professional responsibilities to unqualified person violation of law, rule, order or failure to comply with subpoena conspiring to restrict legal advertising aiding unlawful abortion 64B B

6 FLORIDA REGULATIONS pre-signing prescription forms failure to supervise assisting personnel improper use of substances for muscle building or enhanced athletic performance use of amygdalin (laetrile) misrepresenting or concealing material fact; interfering with investigation or disciplinary proceeding providing opinion on claim without reasonable investigation theft or reproduction of examination 64B PAYMENT FOR SERVICES GRANDFATHER CLAUSE STUDENTS LOCUM TENENS OTHER

7 FLORIDA ~ STATUTE OSTEOPATHIC STATUTE DATE Enacted 1979 REGULATORY BODY PA DEFINED SCOPE OF PRACTICE PRESCRIBING/DISPENSING SUPERVISION DEFINED , and Florida Statutes Council on Physician Assistants; Florida Board of Osteopathic Medicine, Florida Department of Health A person who is a graduate of an approved program or its equivalent or meets standards approved by board and who is licensed to perform medical services delegated by supervising physician (2) Board to adopt by rule the general principles that supervising physicians must use in developing scope of practice of PA under their supervision (4) PA may not be denied clinical hospital privileges except for cause, so long as supervising physician is staff member in good standing (4) Supervising physician may delegate to a fully licensed PA the authority to prescribe or dispense any medication used in the physician s practice unless such medication is listed on the formulary. (Formulary of drugs PAs may not prescribe must include controlled substances, antipsychotics, general anesthetics, radiographic contrast and all parenterals except insulin and epinephrine.) Authority to dispense may only be granted to a PA by a supervising physician who is registered as a dispensing practitioner. PA must inform patient that medication is prescribed or dispensed by a PA and the patient has the right to see the physician prior to prescription being issued. Prior to prescribing or dispensing PA must file evidence of 3 hours of CME in prescriptive practice (evidence of such training as part of PA program accepted), evidence of 3 months of clinical experience in the specialty of the supervising physician and a signed affidavit that the PA has completed 10 hours of CME in the specialty practice in which the PA has prescriptive privileges. Department issues PA a prescriber number. PA must note the prescription or dispensing of medication in the appropriate medical record, and the supervising physician must review and sign each notation (4) Responsible supervision and control. Except in cases of emergency, supervision shall require the easy availability or physical presence of licensed physician for consultation and direction of PA actions. Easy availability includes telecommunication. Board to set rules as to what constitutes reasonable and responsible supervision (2) A physician offering primary health care services may supervise PAs at no more than four satellite offices, in addition to the primary place of practice. A physician offering specialty health care services may supervise PAs at no more than two satellite offices, in addition to the primary place of practice. A physician offering primarily dermatologic or skin care services, which include aesthetic skin care services other than plastic surgery, may only supervise PAs at one satellite office, in addition to the primary place of practice, and must comply with the following requirements: 1. The supervising physician may supervise PAs in a second satellite office until July 1, 2011, if the physician notified the Board of Osteopathic Medicine of the address of the two satellite offices no later than June 30, The physician must be board certified or board-eligible in dermatology or plastic surgery; 3. The satellite office must be within 25 miles of the supervising physician, unless it is in an adjacent county, in which case the distance must be no more than 75 miles from the primary practice location; and 4. PAs in these satellite offices are not required to have their charts reviewed by the supervising physician. A physician who supervises any satellite office must post in each of the offices a current schedule of the regular hours that the physician is present in that office, and the hours that the office is open when the physician is not present. Most institutional supervised settings, such as hospitals, rural health clinics, nursing homes, and medical student and resident training are exempted from the above requirements (3) PAs PER PHYSICIAN APPLICATION Osteopathic physician may not supervise more than 4 currently licensed PAs at any one time (3) PA must apply to the department and submit proof of qualifications, 2 letters of recommendation, sworn statements (7) Upon employment licensed PA must notify department of name, address, license number and specialty of supervising physician (7)

8 FLORIDA ~ STATUTE OSTEOPATHIC QUALIFICATIONS TEMPORARY PERMIT TERMINATION Department shall issue license to each applicant who: is at least 18 years old has passed NCCPA exam (applicant who does not hold a current certificate and has not actively practiced as a PA within the immediately preceding 4 years must retake and successfully complete NCCPA s PANCE exam) has submitted certificate of completion of approved PA program (7) Department may grant temporary license to recent graduate which expires upon receipt of scores from NCCPA or results of agency-administered exam. Expires upon failure of examination. Potential temporary licensee may apply for one-time extension of temporary license after applying for next available examination. If applicant fails exam twice, no longer eligible for temporary license (7) PA must notify board within 30 days of employment or change in supervising physician(s) ( 7) CONTINUING EDUCATION 100 hours biennially or current NCCPA certification (7) TITLE/PRACTICE PROTECTION IDENTIFICATION PHYSICIAN LIABILITY Any person who has not been licensed by council and approved by department who holds himself out as a PA or who uses any other term in indicating or implying that he is a PA, is guilty of third degree felony (11) Each physician using PA is liable for any acts or omissions of the PA under his supervision (15) FEE/RENEWAL SCHEDULE PROGRAM APPROVAL BOARD REPRESENTATION/ ADVISORY COMMITTEE BOARD POWERS DISCIPLINARY POWERS VIOLATIONS/PENALTY PAYMENT FOR SERVICES GRANDFATHER CLAUSE $300 limit on initial PA licensure fee $500 limit on biennial PA license renewal fee (7) Board shall approve PA education programs based on recommendations by the council. Only programs accredited by the Commission on Accreditation of Allied Health Education Programs or its successor will be approved (6) Five member Council on Physician Assistants within the Department of Health. Chairman of the Board of Medicine appoints 3 members who are physician medical board members. One must supervise a PA. Chairman of the Board of Osteopathic Medicine appoints 1 physician board member. Secretary of the department appoints 1 licensed PA. Two members must be physicians who supervise PAs. Council elects chairman annually. The council shall: recommend PAs for licensure develop all rules regulating PAs. Identical rules must be adopted by both boards. make recommendations to the boards regarding all matters relating to PAs (9) Council to establish formulary of drugs that licensed PAs may not prescribe. Formulary must include controlled substances, antipsychotics, general anesthetics, radiographic contrast and all parenterals except insulin and epinephrine. Boards must adopt the formulary (4) Adopt rules necessary for administration of PA process Adopt rules detailing contents of licensure application Adopt rules necessary to ensure continued competency of PAs and their proper utilization by physicians or groups of physicians (13) Deny license, impose sanctions, order probation or place restrictions on PA license, require treatment or CME courses, require additional supervision (7), (9) Deny, suspend or revoke PA license (12) Impose penalties on PA or supervising physician for violation of medical practice act or health professions and occupations statute (7) Health insurance policies must provide payment for PA first assistant if such coverage would have been provided for physician first assistant in surgery

9 FLORIDA ~ STATUTE OSTEOPATHIC STUDENTS Trainee may perform medical services within scope of approved program (5) LOCUM TENENS OTHER

10 FLORIDA ~ OSTEOPATHIC REGULATIONS REGULATIONS Chapter 64B15-6, F.A.C. DATE Revised 11/07 REGULATORY BODY PA DEFINED SCOPE OF PRACTICE PRESCRIBING/DISPENSING SUPERVISION DEFINED PAs PER PHYSICIAN APPLICATION QUALIFICATIONS Florida Board of Osteopathic Medicine Supervising physician shall delegate only tasks and procedures that are within his scope of practice. PA may not perform final diagnosis. Certain duties may be performed only under direct supervision, such as routine insertion of chest tubes, removal of pacer wires, cardiac stress testing, routine insertion of central venous catheters. Administration of general, spinal and epidural anesthesia may be performed under direct supervision (physician on premises) only by PAs who have graduated from board-approved anesthesiology assistant programs. All tasks and procedures performed by PAs must be documented in the appropriate medical record. PA will act in accordance with his or her training and knowledge in medical emergency until physician assumes responsibility for the patient. 64B To prescribe, PA and supervising physician must file application. Prescribing PA must have completed 3 hour course in prescriptive practice after graduation from PA program. Prescribing PA must have completed 3 months of clinical experience in the specialty area of the supervising physician. Board issues prescriber number to PA. 64B Supervising osteopathic physician and prescribing PA shall enter into a written agreement outlining which drugs the osteopathic physician has authorized the PA to prescribe. Agreement to be kept on file at the practice and provided to the Board upon request. 64B PAs may not prescribe controlled substances, antipsychotics, general, spinal or epidural anesthetics, radiographic contrast materials and parenterals (with exception of insulin and epinephrine). Physician may delegate PA to prescribe only drugs used in physician s practice. 64B Only prescribing PAs may dispense sample drugs to patients. All sample dispensing must be done without charge to the patient and PAs may only dispense those drugs that they are authorized to prescribe. PAs practicing in county health departments may dispense prepackaged and prelabeled medications. 64B Responsible supervision means the physician s ability to exercise control and provide direction over PA services. Requires easy availability or physical presence of supervising physician. Factors to be considered in judging if supervision is adequate include task complexity, patient risk, PA s skill, setting, physician availability, necessity for immediate attention and number of other persons that the physician must supervise. Direct supervision refers to physical presence of supervising physician on the premises. Indirect supervision means to easy availability, including ability to communicate by telecommunication. Supervising physician must be within reasonable physical proximity. 64B Supervising physician must review and sign PA s medical records within 7 days during initial 6 months of supervision; within 30 days thereafter. 64B Application for certification must be submitted on board forms, including 2 letters of recommendation from physicians. 64B Applicants who have not passed PANCE exam within 5 attempts must complete 3 months of full-time review course in accredited PA program. Applicants must submit statements attesting to completion of 2 hours of CME on prevention of medical errors. 64B TEMPORARY PERMIT

11 FLORIDA OSTEOPATHIC REGULATIONS TERMINATION CONTINUING EDUCATION Supervising physician must notify council in writing within 30 days of any termination of PA supervised. 64B All certified PAs shall obtain 100 hours of CME biennially that have been approved by the AAPA and logged with either AAPA or NCCPA. Must submit statement documenting completion of 2 hours in prevention of medical errors. Prescribing PAs must complete a minimum of 10 hours of CME in specialty area of supervising physician biennially (these hours may be used to meet 100 hour requirement). PA must complete 2 hours of CME in domestic violence every 6 years. PA must document 1 hour of HIV/AIDS CME prior to renewing license for the first time. 64B TITLE/PRACTICE PROTECTION IDENTIFICATION PHYSICIAN LIABILITY Licensees shall identify themselves as PAs in one of the following manners: (1) wearing a name tag identifying themselves as PAs ;(2) wearing of an article of clothing on the upper body which identifies them as PAs; (3) verbally disclosing themselves as PAs to patients; (4) providing patients with written documentation (e.g. business card) identifying themselves as PAs (5) placing photos identifying PAs in the lobby or waiting room of practice location. 64B Physician assumes responsibility and legal liability for services rendered by PA at all times PA is under his supervision. 64B FEE/RENEWAL SCHEDULE $100 application fee $200 initial certification as PA $200 prescriptive authority fee $150 biennial renewal of PA certification $150 biennial renewal fee for prescribing PA 64B PROGRAM APPROVAL BOARD REPRESENTATION/ ADVISORY COMMITTEE BOARD POWERS Any PA program wishing to be approved and recognized must maintain accreditation with CAAHEP or its successor or have been accredited by CAHEA. 64B DISCIPLINARY POWERS Issue notice of noncompliance 64B Denial, reprimand, letter of concern, fines, probation, suspension, revocation. 64B VIOLATIONS/PENALTY Grounds for disciplinary action include: failure to include disclosure statement in advertisement failure to notify board of change of practice location failure to clearly identify self as PA failure to report change in supervising physician obtaining license renewal by negligent misrepresentation practicing on inactive or delinquent license fraud in attempting to obtain license action taken against license in another jurisdiction guilty of crime directly relating to practice false advertising failure to report another licensee in violation aiding unlicensed practice failure to document required CME failure to report conviction of crime failure to disclose financial interest to patient failure to perform legal obligation filing a false report or failure to file kickbacks or fee splitting sexual misconduct fraudulent representations of medical practice improper solicitation of patients failure to keep written medical records exercising influence on patient for financial gain 64B B

12 FLORIDA OSTEOPATHIC REGULATIONS performing professional services not authorized by patient inappropriate prescribing prescribing or dispensing scheduled drug to self inability to practice with skill and safety malpractice; practicing below acceptable standard of care performing experimental treatment without informed consent practicing beyond permitted scope delegation of professional responsibilities to unqualified person violation of law, rule, order or failure to comply with subpoena conspiring to restrict legal advertising aiding unlawful abortion pre-signing prescription forms failure to supervise assisting personnel improper use of substances for muscle building or enhanced athletic performance use of amygdalin (laetrile) misrepresenting or concealing material fact; interfering with investigation or disciplinary proceeding providing opinion on claim without reasonable investigation theft or reproduction of examination 64B PAYMENT FOR SERVICES GRANDFATHER CLAUSE STUDENTS LOCUM TENENS OTHER

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